Possible Viagra approval – expert sees advantages and disadvantages

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Expert sees advantages and disadvantages
Medicines Agency advises on the release of sexual enhancers

The sexual enhancer Viagra can be an effective measure against erection problems – but if taken regularly, it also poses health risks

© Raphael Huenerfauth/ / Picture Alliance

The drug authority BfArM advises on the release of the sexual enhancer Viagra. So far, the baby blue tablets are only available on prescription. Free access could fight black market trading – but it also entails major risks.

Next Monday, January 25th, a panel of experts from the drug authority BfArM in Bonn will advise on the release of the active ingredient sildenafil from the prescription requirement. This means that Viagra and other sexual enhancers could possibly be available in German pharmacies without a prescription.

Viagra clearance could restrict black market

Prof. Frank Sommer, President of the German Society for Men and Health, sees advantages and disadvantages. In his eyes, the biggest pro would be that the bottom would be pulled out of the black market on the Internet. “We did a study a few years ago, where we examined 22 products that you can order freely on the Internet and found that more than 80 percent didn’t contain what was stated. For example, we had a group there the dose was four times as high.” If you take it regularly, you have a very high risk of heart damage. The scientists also found contamination with heavy metals, for example.

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A distinction must be made between the black market with counterfeit branded products and online offers from doctors, where the interested party first fills out a medical questionnaire and then, if necessary, Viagra or another drug is prescribed and sent from abroad. According to Sommer, one can at least assume that one is receiving the original product. However, the price is not without: Four of the baby blue Viagra diamond tablets can cost around 60 euros.

Sommer, who was the first doctor to be appointed professor of men’s health in 2005, also sees some disadvantages if sildenafil should be available without a prescription in the future. “An erectile dysfunction, if it is caused by blood vessels, is the harbinger of a heart attack or stroke. We recognize this when we examine the blood vessels about eight years in advance. And then you still have time to take appropriate countermeasures. But if you don’t even see a doctor, that falls away.”

Lack of treatment prolongs suffering

If the underlying disease is not treated, the erectile dysfunction will continue to worsen. “There can be damaged nerves, the infrastructure of the penis, the blood vessels that lead to the penis – there are many causes and that’s why it takes up to three hours to find out. But if this doesn’t happen, the suffering continues to worsen . And that’s why you need higher and higher doses to still achieve an erection. Until at some point even the highest is no longer enough. But if you only go to the doctor then, it’s often too late for a cure.”

Another risk: the patient may not have an overview of which drugs are incompatible with sildenafil. “There are heart drugs that have nitrates.” If these were taken together with sildenafil, a so-called hypotensive shock leading to death could result.

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Cinnamon is not just cinnamon. There is real cinnamon or Ceylon cinnamon as well as cassia cinnamon, which originally comes from China. This one is sweeter, more flavorful, and cheaper. In Europe and the USA it is mainly used in the kitchen. Most studies on the health effects are also carried out with cassia cinnamon: it promotes appetite, stimulates intestinal activity and counteracts feelings of fullness and flatulence – making food more digestible. Some fungal diseases and bacteria can be combated with cinnamon extracts. A number of laboratory tests show that cassia cinnamon can also lower blood sugar levels. Both the release of insulin and the uptake of glucose into the cells were higher. Human studies, however, are somewhat conflicting: some show that taking at least 1 gram daily over a long period of time improves insulin action and fat burning. Others could not prove this effect. Cassia cinnamon also contains the ingredient coumarin, which can damage the liver in weakened and sensitive individuals.

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Erection problems are rarely psychological

The decision to be released from the prescription requirement is therefore a difficult consideration. “I would advise listening to both sides,” says Sommer. “The pharmaceutical side, which advocates the release, but also the independent scientists.”

Overall, the discovery of sildenafil as a sexual enhancer by the US company Pfizer was “a godsend,” says Sommer. On the one hand, because the subject of erectile dysfunction has emerged from the taboo zone as a result of extensive media coverage. And secondly, because this resulted in a series of scientific investigations.

“Then it was only just shown that the condition of the penis vessels can predict a heart attack. Since then, diabetes has also been diagnosed much earlier.” In the 1980s, however, the prevailing view was that 90 percent of erectile dysfunction was psychological. “Today, the state of the art is that it’s exactly the opposite: 80 to 90 percent have physical causes, and then the fear of failure might come on top of that.”

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